Egresos Hospitalarios

Aquí se presentan todos los recursos que se utilizaron para mapear la información de los egresos hospitalarios.

  1. Definición de estructura para los datos de los egresos hospitalarios, aqui se definen principalmente los campos utilizados del recurso Encounter de HL7 FHIR. También puedes encontrar el recurso en https://simplifier.net/test-api-minsal/encounteregresoshospv3.

status
subjectReference(Patient_apimin_v3)
end
length
conditionReference(Condition_egresosHosp_apimin_v3)
locationReference(Location_apimin_v3)

  1. Definición de estructura para los datos del paciente. También puedes encontrar el recurso en https://simplifier.net/test-api-minsal/Patientapiminv3.

system
valueS
birthDateS

  1. Definición de estructura para los datos del establecimiento. También puedes encontrar el recurso en https://simplifier.net/test-api-minsal/organizationapimin.

system
value
name
text

  1. Definición de estructura para los datos de las condiciones crónicas. También puedes encontrar el recurso en https://simplifier.net/test-api-minsal/conditionegresoshospapiminv3.

code
display
textS

Búsquedas

Parámetros de Búsqueda Egresos Hospitalarios

Nombre Tipo Descripción Expresión Ejemplo
subject token Utilizado como el rut del paciente sin dígito verificador Encounter.subject subject.identifier=1111111
_profile token Utilizado como parametro identificador de esquema de datos por minsal y perfil FHIR _profile _profile=http://cens.cl/fhir/StructureDefinition/hospitaldigital-egresosHospitalarios
date date Fecha de egreso en formato YYYY-MM-DD Encounter.date date=ge2018-10-12
date=lt2018-10-12
date=2018-10-12
reason token Selección de tipo de egreso(intento de suicidio, condición crónica) Encounter.reason reason=condicionesCronicas
reason=intentosSuicidio

Prefijos implementados para búsquedas por fecha

Expresión Definición Ejemplo Significado
ge Mayor o Igual que ge2018-10-12 Resultados con fecha posterior o igual a 2018-10-12
lt Menor que lt2018-10-12 Resultados con fecha anterior a 2018-10-12

Referencia: Documentación completa en FHIR

Ejemplos de búsqueda

  • Búsqueda solo por rut
    GET [base]/Encounter?subject.identifier=10533196&_profile=http://cens.cl/fhir/StructureDefinition/hospitaldigital-egresosHospitalarios
    
  • Búsqueda por rut y rango de fechas
    GET [base]/Encounter?subject.identifier=10533196&_profile=http://cens.cl/fhir/StructureDefinition/hospitaldigital-egresosHospitalarios&date=ge2017-06-12&date=lt2017-06-14
    
  • Búsqueda de condiciones crónicas por rut
    GET [base]/Encounter?subject:Patient.identifier=19824900&reason=condicionesCronicas&_profile=http://cens.cl/fhir/StructureDefinition/hospitaldigital-egresosHospitalarios
    
  • Búsqueda de intentos de suicidio por rut
    GET [base]/Encounter?subject:Patient.identifier=19824900&reason=intentosSuicidio&_profile=http://cens.cl/fhir/StructureDefinition/hospitaldigital-egresosHospitalarios
    
  • Búsqueda de condiciones crónicas por rut y fecha
    GET [base]/Encounter?subject.identifier=10533196&_profile=http://cens.cl/fhir/StructureDefinition/hospitaldigital-egresosHospitalarios&date=ge2017-06-12&date=lt2017-06-14&reason=condicionesCronicas
    
  • Búsqueda de intentos de suicidio por rut y fecha
    GET [base]/Encounter?subject.identifier=10533196&_profile=http://cens.cl/fhir/StructureDefinition/hospitaldigital-egresosHospitalarios&date=ge2017-06-12&date=lt2017-06-14&reason=intentosSuicidio
    

Ejemplo de response

{
    "resourceType": "Bundle",
    "id": "c2fa3bd1-59c0-488b-bfa0-7ef82e2907c8",
    "meta": {
        "lastUpdated": "2019-01-14T23:08:04.032-03:00"
    },
    "type": "searchset",
    "total": 1,
    "link": [
        {
            "relation": "self",
            "url": "http://192.168.60.24:8080/hospital-digital-fhir-server-3.0/fhir/Encounter?_profile=http%3A%2F%2Fcens.cl%2Ffhir%2FStructureDefinition%2Fhospitaldigital-egresosHospitalarios&date=ge2017-06-12&date=lt2017-06-14&subject.identifier=10533196"
        }
    ],
    "entry": [
        {
            "fullUrl": "http://192.168.60.24:8080/hospital-digital-fhir-server-3.0/fhir/Encounter/339776154",
            "resource": {
                "resourceType": "Encounter",
                "id": "339776154",
                "contained": [
                    {
                        "resourceType": "Patient",
                        "id": "p1",
                        "identifier": [
                            {
                                "system": "https://www.srcei.cl/RUT",
                                "value": "10533196"
                            }
                        ]
                    },
                    {
                        "resourceType": "Condition",
                        "id": "con1",
                        "code": {
                            "text": "COLECISTITIS CRÓNICA/CÁLCULOS BILIARES"
                        }
                    },
                    {
                        "resourceType": "Condition",
                        "id": "con2",
                        "code": {
                            "coding": [
                                {
                                    "code": "K802",
                                    "display": "CALCULO DE LA VESICULA BILIAR SIN COLECISTITIS"
                                }
                            ],
                            "text": "Diagnostico Principal"
                        }
                    },
                    {
                        "resourceType": "Condition",
                        "id": "con3",
                        "code": {
                            "text": "Causa Externa"
                        }
                    },
                    {
                        "resourceType": "Location",
                        "id": "loc",
                        "identifier": [
                            {
                                "system": "http://www.deis.cl",
                                "value": "111295"
                            }
                        ],
                        "name": "Clínica Bicentenario"
                    }
                ],
                "status": "finished",
                "type": [
                    {
                        "coding": [
                            {
                                "system": "http://browser.ihtsdotools.org",
                                "code": "27624003",
                                "display": "enfermedad crónica"
                            }
                        ]
                    }
                ],
                "subject": {
                    "reference": "#p1"
                },
                "period": {
                    "start": "2017-06-12T00:00:00-04:00",
                    "end": "2017-06-13T00:00:00-04:00"
                },
                "length": {
                    "value": 1
                },
                "diagnosis": [
                    {
                        "condition": {
                            "reference": "#con1"
                        }
                    },
                    {
                        "condition": {
                            "reference": "#con2"
                        }
                    },
                    {
                        "condition": {
                            "reference": "#con3"
                        }
                    }
                ],
                "location": [
                    {
                        "location": {
                            "reference": "#loc"
                        }
                    }
                ]
            }
        }
    ]
}

Dicccionario de Datos

Diccionario de Encounter

Encounter
DefinitionAn interaction between a patient and healthcare provider(s) for the purpose of providing healthcare service(s) or assessing the health status of a patient.
Cardinality0...*
AliasVisit
Invariants
  • dom-2: If the resource is contained in another resource, it SHALL NOT contain nested Resources
    contained.contained.empty()
  • dom-1: If the resource is contained in another resource, it SHALL NOT contain any narrative
    contained.text.empty()
  • dom-4: If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated
    contained.meta.versionId.empty() and contained.meta.lastUpdated.empty()
  • dom-3: If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource
    contained.where(('#'+id in %resource.descendants().reference).not()).empty()
Mappings
  • rim: Entity. Role, or Act
  • rim: Encounter[@moodCode='EVN']
  • w5: workflow.encounter
Encounter.id
DefinitionThe logical id of the resource, as used in the URL for the resource. Once assigned, this value never changes.
Cardinality0...1
Typeid
SummaryTrue
Comments

The only time that a resource does not have an id is when it is being submitted to the server using a create operation.

Invariants
  • ele-1: All FHIR elements must have a @value or children
    hasValue() | (children().count() > id.count())
Mappings
  • rim: n/a
Encounter.meta
DefinitionThe metadata about the resource. This is content that is maintained by the infrastructure. Changes to the content may not always be associated with version changes to the resource.
Cardinality0...1
TypeMeta
SummaryTrue
Invariants
  • ele-1: All FHIR elements must have a @value or children
    hasValue() | (children().count() > id.count())
Mappings
  • rim: n/a
  • rim: N/A
Encounter.implicitRules
DefinitionA reference to a set of rules that were followed when the resource was constructed, and which must be understood when processing the content.
Cardinality0...1
Typeuri
ModifierTrue
SummaryTrue
Comments

Asserting this rule set restricts the content to be only understood by a limited set of trading partners. This inherently limits the usefulness of the data in the long term. However, the existing health eco-system is highly fractured, and not yet ready to define, collect, and exchange data in a generally computable sense. Wherever possible, implementers and/or specification writers should avoid using this element.

This element is labelled as a modifier because the implicit rules may provide additional knowledge about the resource that modifies it's meaning or interpretation.

Invariants
  • ele-1: All FHIR elements must have a @value or children
    hasValue() | (children().count() > id.count())
Mappings
  • rim: n/a
Encounter.language
DefinitionThe base language in which the resource is written.
Cardinality0...1
Typecode
Binding
A human language.
?? (extensible)
Comments

Language is provided to support indexing and accessibility (typically, services such as text to speech use the language tag). The html language tag in the narrative applies to the narrative. The language tag on the resource may be used to specify the language of other presentations generated from the data in the resource Not all the content has to be in the base language. The Resource.language should not be assumed to apply to the narrative automatically. If a language is specified, it should it also be specified on the div element in the html (see rules in HTML5 for information about the relationship between xml:lang and the html lang attribute).

Invariants
  • ele-1: All FHIR elements must have a @value or children
    hasValue() | (children().count() > id.count())
Mappings
  • rim: n/a
Encounter.text
DefinitionA human-readable narrative that contains a summary of the resource, and may be used to represent the content of the resource to a human. The narrative need not encode all the structured data, but is required to contain sufficient detail to make it "clinically safe" for a human to just read the narrative. Resource definitions may define what content should be represented in the narrative to ensure clinical safety.
Cardinality0...1
TypeNarrative
Aliasnarrative, html, xhtml, display
Comments

Contained resources do not have narrative. Resources that are not contained SHOULD have a narrative. In some cases, a resource may only have text with little or no additional discrete data (as long as all minOccurs=1 elements are satisfied). This may be necessary for data from legacy systems where information is captured as a "text blob" or where text is additionally entered raw or narrated and encoded in formation is added later.

Invariants
  • ele-1: All FHIR elements must have a @value or children
    hasValue() | (children().count() > id.count())
Mappings
  • rim: n/a
  • rim: N/A
  • rim: Act.text?
Encounter.contained
DefinitionThese resources do not have an independent existence apart from the resource that contains them - they cannot be identified independently, and nor can they have their own independent transaction scope.
Cardinality0...*
TypeResource
Aliasinline resources, anonymous resources, contained resources
Comments

This should never be done when the content can be identified properly, as once identification is lost, it is extremely difficult (and context dependent) to restore it again.

Mappings
  • rim: Entity. Role, or Act
  • rim: N/A
Encounter.extension
DefinitionMay be used to represent additional information that is not part of the basic definition of the resource. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.
Cardinality0...*
TypeExtension
Aliasextensions, user content
Comments

There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

SlicingUnordered, Open, by url(Value)
Invariants
  • ele-1: All FHIR elements must have a @value or children
    hasValue() | (children().count() > id.count())
  • ext-1: Must have either extensions or value[x], not both
    extension.exists() != value.exists()
Mappings
  • rim: n/a
  • rim: N/A
Encounter.modifierExtension
DefinitionMay be used to represent additional information that is not part of the basic definition of the resource, and that modifies the understanding of the element that contains it. Usually modifier elements provide negation or qualification. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.
Cardinality0...*
TypeExtension
ModifierTrue
Aliasextensions, user content
Comments

There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

SlicingUnordered, Open, by url(Value)
Invariants
  • ele-1: All FHIR elements must have a @value or children
    hasValue() | (children().count() > id.count())
  • ext-1: Must have either extensions or value[x], not both
    extension.exists() != value.exists()
Mappings
  • rim: n/a
  • rim: N/A
Encounter.identifier
DefinitionIdentifier(s) by which this encounter is known.
Cardinality0...*
TypeIdentifier
SummaryTrue
Invariants
  • ele-1: All FHIR elements must have a @value or children
    hasValue() | (children().count() > id.count())
Mappings
  • rim: n/a
  • v2: CX / EI (occasionally, more often EI maps to a resource id or a URL)
  • rim: II - see see identifier pattern at http://wiki.hl7.org/index.php?title=Common_Design_Patterns#Identifier_Pattern for relevant discussion. The Identifier class is a little looser than the v3 type II because it allows URIs as well as registered OIDs or GUIDs. Also maps to Role[classCode=IDENT]
  • servd: Identifier
  • v2: PV1-19
  • rim: .id
  • w5: id
Encounter.status
DefinitionSe define el estado del encuentro.
Cardinality1...1
Typecode
Binding
Current state of the encounter
?? (required)
ModifierTrue
SummaryTrue
Comments

Note that internal business rules will detemine the appropraite transitions that may occur between statuses (and also classes).

This element is labeled as a modifier because the status contains codes that mark the encounter as not currently valid.

Invariants
  • ele-1: All FHIR elements must have a @value or children
    hasValue() | (children().count() > id.count())
Mappings
  • rim: n/a
  • v2: No clear equivalent in HL7 v2; active/finished could be inferred from PV1-44, PV1-45, PV2-24; inactive could be inferred from PV2-16
  • rim: .statusCode
  • w5: status
  • api-minsal: tipo_fuente
Encounter.statusHistory
DefinitionThe status history permits the encounter resource to contain the status history without needing to read through the historical versions of the resource, or even have the server store them.
Cardinality0...*
TypeBackboneElement
Comments

The current status is always found in the current version of the resource, not the status history.

Invariants
  • ele-1: All FHIR elements must have a @value or children
    hasValue() | (children().count() > id.count())
Mappings
  • rim: n/a
Encounter.statusHistory.id
Definitionunique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
Cardinality0...1
Typestring
Comments

Note that FHIR strings may not exceed 1MB in size

Invariants
  • ele-1: All FHIR elements must have a @value or children
    hasValue() | (children().count() > id.count())
Mappings
  • rim: n/a
Encounter.statusHistory.extension
DefinitionMay be used to represent additional information that is not part of the basic definition of the element. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.
Cardinality0...*
TypeExtension
Aliasextensions, user content
Comments

There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

SlicingUnordered, Open, by url(Value)
Invariants
  • ele-1: All FHIR elements must have a @value or children
    hasValue() | (children().count() > id.count())
  • ext-1: Must have either extensions or value[x], not both
    extension.exists() != value.exists()
Mappings
  • rim: n/a
  • rim: N/A
Encounter.statusHistory.modifierExtension
DefinitionMay be used to represent additional information that is not part of the basic definition of the element, and that modifies the understanding of the element that contains it. Usually modifier elements provide negation or qualification. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.
Cardinality0...*
TypeExtension
ModifierTrue
SummaryTrue
Aliasextensions, user content, modifiers
Comments

There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

Invariants
  • ele-1: All FHIR elements must have a @value or children
    hasValue() | (children().count() > id.count())
  • ext-1: Must have either extensions or value[x], not both
    extension.exists() != value.exists()
Mappings
  • rim: n/a
  • rim: N/A
Encounter.statusHistory.status
Definitionplanned | arrived | triaged | in-progress | onleave | finished | cancelled +.
Cardinality1...1
Typecode
Binding
Current state of the encounter
?? (required)
Comments

Note that FHIR strings may not exceed 1MB in size

Invariants
  • ele-1: All FHIR elements must have a @value or children
    hasValue() | (children().count() > id.count())
Mappings
  • rim: n/a
Encounter.statusHistory.period
DefinitionThe time that the episode was in the specified status.
Cardinality1...1
TypePeriod
Comments

This is not a duration - that's a measure of time (a separate type), but a duration that occurs at a fixed value of time. A Period specifies a range of time; the context of use will specify whether the entire range applies (e.g. "the patient was an inpatient of the hospital for this time range") or one value from the range applies (e.g. "give to the patient between these two times"). If duration is required, specify the type as Interval|Duration.

Invariants
  • ele-1: All FHIR elements must have a @value or children
    hasValue() | (children().count() > id.count())
  • per-1: If present, start SHALL have a lower value than end
    start.empty() or end.empty() or (start <= end)
Mappings
  • rim: n/a
  • v2: DR
  • rim: IVL<TS>[lowClosed="true" and highClosed="true"] or URG<TS>[lowClosed="true" and highClosed="true"]
Encounter.class
Definitioninpatient | outpatient | ambulatory | emergency +.
Cardinality0...1
TypeCoding
Binding
Classification of the encounter
?? (extensible)
SummaryTrue
Comments

Codes may be defined very casually in enumerations or code lists, up to very formal definitions such as SNOMED CT - see the HL7 v3 Core Principles for more information.

Invariants
  • ele-1: All FHIR elements must have a @value or children
    hasValue() | (children().count() > id.count())
Mappings
  • rim: n/a
  • v2: CE/CNE/CWE subset one of the sets of component 1-3 or 4-6
  • rim: CV
  • orim: fhir:Coding rdfs:subClassOf dt:CDCoding
  • v2: PV1-2
  • rim: .inboundRelationship[typeCode=SUBJ].source[classCode=LIST].code
  • w5: class
Encounter.classHistory
DefinitionThe class history permits the tracking of the encounters transitions without needing to go through the resource history. This would be used for a case where an admission starts of as an emergency encounter, then transisions into an inpatient scenario. Doing this and not restarting a new encounter ensures that any lab/diagnostic results can more easily follow the patient and not require re-processing and not get lost or cancelled during a kindof discharge from emergency to inpatient.
Cardinality0...*
TypeBackboneElement
Invariants
  • ele-1: All FHIR elements must have a @value or children
    hasValue() | (children().count() > id.count())
Mappings
  • rim: n/a
Encounter.classHistory.id
Definitionunique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
Cardinality0...1
Typestring
Comments

Note that FHIR strings may not exceed 1MB in size

Invariants
  • ele-1: All FHIR elements must have a @value or children
    hasValue() | (children().count() > id.count())
Mappings
  • rim: n/a
Encounter.classHistory.extension
DefinitionMay be used to represent additional information that is not part of the basic definition of the element. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.
Cardinality0...*
TypeExtension
Aliasextensions, user content
Comments

There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

SlicingUnordered, Open, by url(Value)
Invariants
  • ele-1: All FHIR elements must have a @value or children
    hasValue() | (children().count() > id.count())
  • ext-1: Must have either extensions or value[x], not both
    extension.exists() != value.exists()
Mappings
  • rim: n/a
  • rim: N/A
Encounter.classHistory.modifierExtension
DefinitionMay be used to represent additional information that is not part of the basic definition of the element, and that modifies the understanding of the element that contains it. Usually modifier elements provide negation or qualification. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.
Cardinality0...*
TypeExtension
ModifierTrue
SummaryTrue
Aliasextensions, user content, modifiers
Comments

There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

Invariants
  • ele-1: All FHIR elements must have a @value or children
    hasValue() | (children().count() > id.count())
  • ext-1: Must have either extensions or value[x], not both
    extension.exists() != value.exists()
Mappings
  • rim: n/a
  • rim: N/A
Encounter.classHistory.class
Definitioninpatient | outpatient | ambulatory | emergency +.
Cardinality1...1
TypeCoding
Binding
Classification of the encounter
?? (extensible)
Comments

Codes may be defined very casually in enumerations or code lists, up to very formal definitions such as SNOMED CT - see the HL7 v3 Core Principles for more information.

Invariants
  • ele-1: All FHIR elements must have a @value or children
    hasValue() | (children().count() > id.count())
Mappings
  • rim: n/a
  • v2: CE/CNE/CWE subset one of the sets of component 1-3 or 4-6
  • rim: CV
  • orim: fhir:Coding rdfs:subClassOf dt:CDCoding
Encounter.classHistory.period
DefinitionThe time that the episode was in the specified class.
Cardinality1...1
TypePeriod
Comments

This is not a duration - that's a measure of time (a separate type), but a duration that occurs at a fixed value of time. A Period specifies a range of time; the context of use will specify whether the entire range applies (e.g. "the patient was an inpatient of the hospital for this time range") or one value from the range applies (e.g. "give to the patient between these two times"). If duration is required, specify the type as Interval|Duration.

Invariants
  • ele-1: All FHIR elements must have a @value or children
    hasValue() | (children().count() > id.count())
  • per-1: If present, start SHALL have a lower value than end
    start.empty() or end.empty() or (start <= end)
Mappings
  • rim: n/a
  • v2: DR
  • rim: IVL<TS>[lowClosed="true" and highClosed="true"] or URG<TS>[lowClosed="true" and highClosed="true"]
Encounter.type
DefinitionSpecific type of encounter (e.g. e-mail consultation, surgical day-care, skilled nursing, rehabilitation).
Cardinality0...*
TypeCodeableConcept
Binding
The type of encounter
?? (example)
SummaryTrue
Comments

Since there are many ways to further classify encounters, this element is 0..*.

Invariants
  • ele-1: All FHIR elements must have a @value or children
    hasValue() | (children().count() > id.count())
Mappings
  • rim: n/a
  • v2: CE/CNE/CWE
  • rim: CD
  • orim: fhir:CodeableConcept rdfs:subClassOf dt:CD
  • v2: PV1-4 / PV1-18
  • rim: .code
  • w5: class
Encounter.priority
DefinitionIndicates the urgency of the encounter.
Cardinality0...1
TypeCodeableConcept
Binding
Indicates the urgency of the encounter.
?? (example)
Comments

Not all terminology uses fit this general pattern. In some cases, models should not use CodeableConcept and use Coding directly and provide their own structure for managing text, codings, translations and the relationship between elements and pre- and post-coordination.

Invariants
  • ele-1: All FHIR elements must have a @value or children
    hasValue() | (children().count() > id.count())
Mappings
  • rim: n/a
  • v2: CE/CNE/CWE
  • rim: CD
  • orim: fhir:CodeableConcept rdfs:subClassOf dt:CD
  • v2: PV2-25
  • rim: .priorityCode
  • w5: grade
Encounter.subject
DefinitionA quien hace referencia el encuentro. Usualmente es a un paciente, pero no siempre es así.
Cardinality0...1
TypeReference(Patient_apimin_v3)
SummaryTrue
Aliaspatient
Comments

While the encounter is always about the patient, the patient may not actually be known in all contexts of use, and there may be a group of patients that could be anonymous (such as in a group therapy for Alcoholics Anonymous - where the recording of the encounter could be used for billing on the number of people/staff and not important to the context of the specific patients) or alternately in veterinary care a herd of sheep receiving treatment (where the animals are not individually tracked).

Invariants
  • ele-1: All FHIR elements must have a @value or children
    hasValue() | (children().count() > id.count())
  • ref-1: SHALL have a contained resource if a local reference is provided
    reference.startsWith('#').not() or (reference.substring(1).trace('url') in %resource.contained.id.trace('ids'))
Mappings
  • rim: n/a
  • rim: The target of a resource reference is a RIM entry point (Act, Role, or Entity)
  • v2: PID-3
  • rim: .participation[typeCode=SBJ]/role[classCode=PAT]
  • w5: who.focus
Encounter.episodeOfCare
DefinitionWhere a specific encounter should be classified as a part of a specific episode(s) of care this field should be used. This association can facilitate grouping of related encounters together for a specific purpose, such as government reporting, issue tracking, association via a common problem. The association is recorded on the encounter as these are typically created after the episode of care, and grouped on entry rather than editing the episode of care to append another encounter to it (the episode of care could span years).
Cardinality0...*
TypeReference(http://hl7.org/fhir/StructureDefinition/EpisodeOfCare)
SummaryTrue
Comments

References SHALL be a reference to an actual FHIR resource, and SHALL be resolveable (allowing for access control, temporary unavailability, etc). Resolution can be either by retrieval from the URL, or, where applicable by resource type, by treating an absolute reference as a canonical URL and looking it up in a local registry/repository.

Invariants
  • ele-1: All FHIR elements must have a @value or children
    hasValue() | (children().count() > id.count())
  • ref-1: SHALL have a contained resource if a local reference is provided
    reference.startsWith('#').not() or (reference.substring(1).trace('url') in %resource.contained.id.trace('ids'))
Mappings
  • rim: n/a
  • rim: The target of a resource reference is a RIM entry point (Act, Role, or Entity)
  • v2: PV1-54, PV1-53
  • w5: context
Encounter.incomingReferral
DefinitionThe referral request this encounter satisfies (incoming referral).
Cardinality0...*
TypeReference(http://hl7.org/fhir/StructureDefinition/ReferralRequest)
Comments

References SHALL be a reference to an actual FHIR resource, and SHALL be resolveable (allowing for access control, temporary unavailability, etc). Resolution can be either by retrieval from the URL, or, where applicable by resource type, by treating an absolute reference as a canonical URL and looking it up in a local registry/repository.

Invariants
  • ele-1: All FHIR elements must have a @value or children
    hasValue() | (children().count() > id.count())
  • ref-1: SHALL have a contained resource if a local reference is provided
    reference.startsWith('#').not() or (reference.substring(1).trace('url') in %resource.contained.id.trace('ids'))
Mappings
  • rim: n/a
  • rim: The target of a resource reference is a RIM entry point (Act, Role, or Entity)
  • rim: .reason.ClinicalDocument
Encounter.participant
DefinitionThe list of people responsible for providing the service.
Cardinality0...*
TypeBackboneElement
SummaryTrue
Invariants
  • ele-1: All FHIR elements must have a @value or children
    hasValue() | (children().count() > id.count())
Mappings
  • rim: n/a
  • v2: ROL
  • rim: .participation[typeCode=PFM]
Encounter.participant.id
Definitionunique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
Cardinality0...1
Typestring
Comments

Note that FHIR strings may not exceed 1MB in size

Invariants
  • ele-1: All FHIR elements must have a @value or children
    hasValue() | (children().count() > id.count())
Mappings
  • rim: n/a
Encounter.participant.extension
DefinitionMay be used to represent additional information that is not part of the basic definition of the element. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.
Cardinality0...*
TypeExtension
Aliasextensions, user content
Comments

There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

SlicingUnordered, Open, by url(Value)
Invariants
  • ele-1: All FHIR elements must have a @value or children
    hasValue() | (children().count() > id.count())
  • ext-1: Must have either extensions or value[x], not both
    extension.exists() != value.exists()
Mappings
  • rim: n/a
  • rim: N/A
Encounter.participant.modifierExtension
DefinitionMay be used to represent additional information that is not part of the basic definition of the element, and that modifies the understanding of the element that contains it. Usually modifier elements provide negation or qualification. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.
Cardinality0...*
TypeExtension
ModifierTrue
SummaryTrue
Aliasextensions, user content, modifiers
Comments

There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

Invariants
  • ele-1: All FHIR elements must have a @value or children
    hasValue() | (children().count() > id.count())
  • ext-1: Must have either extensions or value[x], not both
    extension.exists() != value.exists()
Mappings
  • rim: n/a
  • rim: N/A
Encounter.participant.type
DefinitionRole of participant in encounter.
Cardinality0...*
TypeCodeableConcept
Binding
Role of participant in encounter
?? (extensible)
SummaryTrue
Comments

The participant type indicates how an individual partitipates in an encounter. It includes non-practitioner participants, and for practitioners this is to describe the action type in the context of this encounter (e.g. Admitting Dr, Attending Dr, Translator, Consulting Dr). This is different to the practitioner roles which are functional roles, derived from terms of employment, education, licensing, etc.

Invariants
  • ele-1: All FHIR elements must have a @value or children
    hasValue() | (children().count() > id.count())
Mappings
  • rim: n/a
  • v2: CE/CNE/CWE
  • rim: CD
  • orim: fhir:CodeableConcept rdfs:subClassOf dt:CD
  • v2: ROL-3 (or maybe PRT-4)
  • rim: .functionCode
Encounter.participant.period
DefinitionThe period of time that the specified participant participated in the encounter. These can overlap or be sub-sets of the overall encounter's period.
Cardinality0...1
TypePeriod
Comments

This is not a duration - that's a measure of time (a separate type), but a duration that occurs at a fixed value of time. A Period specifies a range of time; the context of use will specify whether the entire range applies (e.g. "the patient was an inpatient of the hospital for this time range") or one value from the range applies (e.g. "give to the patient between these two times"). If duration is required, specify the type as Interval|Duration.

Invariants
  • ele-1: All FHIR elements must have a @value or children
    hasValue() | (children().count() > id.count())
  • per-1: If present, start SHALL have a lower value than end
    start.empty() or end.empty() or (start <= end)
Mappings
  • rim: n/a
  • v2: DR
  • rim: IVL<TS>[lowClosed="true" and highClosed="true"] or URG<TS>[lowClosed="true" and highClosed="true"]
  • v2: ROL-5, ROL-6 (or maybe PRT-5)
  • rim: .time
Encounter.participant.individual
DefinitionPersons involved in the encounter other than the patient.
Cardinality0...1
TypeReference(http://hl7.org/fhir/StructureDefinition/Practitioner | http://hl7.org/fhir/StructureDefinition/RelatedPerson)
SummaryTrue
Comments

References SHALL be a reference to an actual FHIR resource, and SHALL be resolveable (allowing for access control, temporary unavailability, etc). Resolution can be either by retrieval from the URL, or, where applicable by resource type, by treating an absolute reference as a canonical URL and looking it up in a local registry/repository.

Invariants
  • ele-1: All FHIR elements must have a @value or children
    hasValue() | (children().count() > id.count())
  • ref-1: SHALL have a contained resource if a local reference is provided
    reference.startsWith('#').not() or (reference.substring(1).trace('url') in %resource.contained.id.trace('ids'))
Mappings
  • rim: n/a
  • rim: The target of a resource reference is a RIM entry point (Act, Role, or Entity)
  • v2: ROL-4
  • rim: .role
  • w5: who
Encounter.appointment
DefinitionThe appointment that scheduled this encounter.
Cardinality0...1
TypeReference(http://hl7.org/fhir/StructureDefinition/Appointment)
SummaryTrue
Comments

References SHALL be a reference to an actual FHIR resource, and SHALL be resolveable (allowing for access control, temporary unavailability, etc). Resolution can be either by retrieval from the URL, or, where applicable by resource type, by treating an absolute reference as a canonical URL and looking it up in a local registry/repository.

Invariants
  • ele-1: All FHIR elements must have a @value or children
    hasValue() | (children().count() > id.count())
  • ref-1: SHALL have a contained resource if a local reference is provided
    reference.startsWith('#').not() or (reference.substring(1).trace('url') in %resource.contained.id.trace('ids'))
Mappings
  • rim: n/a
  • rim: The target of a resource reference is a RIM entry point (Act, Role, or Entity)
  • v2: SCH-1 / SCH-2
  • rim: .outboundRelationship[typeCode=FLFS].target[classCode=ENC, moodCode=APT]
Encounter.period
DefinitionThe start and end time of the encounter.
Cardinality0...1
TypePeriod
Comments

If not (yet) known, the end of the Period may be omitted.

Invariants
  • ele-1: All FHIR elements must have a @value or children
    hasValue() | (children().count() > id.count())
  • per-1: If present, start SHALL have a lower value than end
    start.empty() or end.empty() or (start <= end)
Mappings
  • rim: n/a
  • v2: DR
  • rim: IVL<TS>[lowClosed="true" and highClosed="true"] or URG<TS>[lowClosed="true" and highClosed="true"]
  • v2: PV1-44, PV1-45
  • rim: .effectiveTime (low & high)
  • w5: when.done
Encounter.period.id
Definitionunique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
Cardinality0...1
Typestring
Comments

Note that FHIR strings may not exceed 1MB in size

Invariants
  • ele-1: All FHIR elements must have a @value or children
    hasValue() | (children().count() > id.count())
Mappings
  • rim: n/a
Encounter.period.extension
DefinitionMay be used to represent additional information that is not part of the basic definition of the element. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.
Cardinality0...*
TypeExtension
Aliasextensions, user content
Comments

There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

SlicingUnordered, Open, by url(Value)
Invariants
  • ele-1: All FHIR elements must have a @value or children
    hasValue() | (children().count() > id.count())
  • ext-1: Must have either extensions or value[x], not both
    extension.exists() != value.exists()
Mappings
  • rim: n/a
  • rim: N/A
Encounter.period.start
DefinitionThe start of the period. The boundary is inclusive.
Cardinality0...1
TypedateTime
SummaryTrue
Comments

If the low element is missing, the meaning is that the low boundary is not known.

Invariants
  • ele-1: All FHIR elements must have a @value or children
    hasValue() | (children().count() > id.count())
Mappings
  • rim: n/a
  • v2: DR.1
  • rim: ./low
Encounter.period.end
DefinitionThe end of the period. If the end of the period is missing, it means that the period is ongoing. The start may be in the past, and the end date in the future, which means that period is expected/planned to end at that time.
Cardinality0...1
TypedateTime
SummaryTrue
Comments

The high value includes any matching date/time. i.e. 2012-02-03T10:00:00 is in a period that has a end value of 2012-02-03.

Invariants
  • ele-1: All FHIR elements must have a @value or children
    hasValue() | (children().count() > id.count())
Mappings
  • rim: n/a
  • v2: DR.2
  • rim: ./high
  • api-minsal: fecha_egreso
Encounter.length
DefinitionCantidad de días en que se llevo a cabo el encuentro.
Cardinality0...1
TypeDuration
Comments

May differ from the time the Encounter.period lasted because of leave of absence.

Invariants
  • ele-1: All FHIR elements must have a @value or children
    hasValue() | (children().count() > id.count())
  • qty-3: If a code for the unit is present, the system SHALL also be present
    code.empty() or system.exists()
  • drt-1: There SHALL be a code if there is a value and it SHALL be an expression of time. If system is present, it SHALL be UCUM.
    code.exists() implies ((system = %ucum) and value.exists())
Mappings
  • rim: n/a
  • v2: SN (see also Range) or CQ
  • rim: PQ, IVL<PQ>, MO, CO, depending on the values
  • rim: PQ, IVL<PQ> depending on the values
  • v2: (PV1-45 less PV1-44) iff ( (PV1-44 not empty) and (PV1-45 not empty) ); units in minutes
  • rim: .lengthOfStayQuantity
Encounter.reason
DefinitionReason the encounter takes place, expressed as a code. For admissions, this can be used for a coded admission diagnosis.
Cardinality0...*
TypeCodeableConcept
Binding
Reason why the encounter takes place.
?? (preferred)
SummaryTrue
AliasIndication, Admission diagnosis
Comments

For systems that need to know which was the primary diagnosis, these will be marked with the standard extension primaryDiagnosis (which is a sequence value rather than a flag, 1 = primary diagnosis).

Invariants
  • ele-1: All FHIR elements must have a @value or children
    hasValue() | (children().count() > id.count())
Mappings
  • rim: n/a
  • v2: CE/CNE/CWE
  • rim: CD
  • orim: fhir:CodeableConcept rdfs:subClassOf dt:CD
  • v2: EVN-4 / PV2-3 (note: PV2-3 is nominally constrained to inpatient admissions; HL7 v2 makes no vocabulary suggestions for PV2-3; would not expect PV2 segment or PV2-3 to be in use in all implementations )
  • rim: .reasonCode
  • w5: why
Encounter.diagnosis
DefinitionThe list of diagnosis relevant to this encounter.
Cardinality0...*
TypeBackboneElement
SummaryTrue
Invariants
  • ele-1: All FHIR elements must have a @value or children
    hasValue() | (children().count() > id.count())
Mappings
  • rim: n/a
  • rim: .outboundRelationship[typeCode=RSON]
Encounter.diagnosis.id
Definitionunique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
Cardinality0...1
Typestring
Comments

Note that FHIR strings may not exceed 1MB in size

Invariants
  • ele-1: All FHIR elements must have a @value or children
    hasValue() | (children().count() > id.count())
Mappings
  • rim: n/a
Encounter.diagnosis.extension
DefinitionMay be used to represent additional information that is not part of the basic definition of the element. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.
Cardinality0...*
TypeExtension
Aliasextensions, user content
Comments

There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

SlicingUnordered, Open, by url(Value)
Invariants
  • ele-1: All FHIR elements must have a @value or children
    hasValue() | (children().count() > id.count())
  • ext-1: Must have either extensions or value[x], not both
    extension.exists() != value.exists()
Mappings
  • rim: n/a
  • rim: N/A
Encounter.diagnosis.modifierExtension
DefinitionMay be used to represent additional information that is not part of the basic definition of the element, and that modifies the understanding of the element that contains it. Usually modifier elements provide negation or qualification. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.
Cardinality0...*
TypeExtension
ModifierTrue
SummaryTrue
Aliasextensions, user content, modifiers
Comments

There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

Invariants
  • ele-1: All FHIR elements must have a @value or children
    hasValue() | (children().count() > id.count())
  • ext-1: Must have either extensions or value[x], not both
    extension.exists() != value.exists()
Mappings
  • rim: n/a
  • rim: N/A
Encounter.diagnosis.condition
DefinitionReason the encounter takes place, as specified using information from another resource. For admissions, this is the admission diagnosis. The indication will typically be a Condition (with other resources referenced in the evidence.detail), or a Procedure.
Cardinality1...1
TypeReference(Condition_egresosHosp_apimin_v3)
AliasAdmission diagnosis, discharge diagnosis, indication
Comments

For systems that need to know which was the primary diagnosis, these will be marked with the standard extension primaryDiagnosis (which is a sequence value rather than a flag, 1 = primary diagnosis).

Invariants
  • ele-1: All FHIR elements must have a @value or children
    hasValue() | (children().count() > id.count())
  • ref-1: SHALL have a contained resource if a local reference is provided
    reference.startsWith('#').not() or (reference.substring(1).trace('url') in %resource.contained.id.trace('ids'))
Mappings
  • rim: n/a
  • rim: The target of a resource reference is a RIM entry point (Act, Role, or Entity)
  • v2: Resources that would commonly referenced at Encounter.indication would be Condition and/or Procedure. These most closely align with DG1/PRB and PR1 respectively.
  • rim: .outboundRelationship[typeCode=RSON].target
  • w5: why
Encounter.diagnosis.role
DefinitionRole that this diagnosis has within the encounter (e.g. admission, billing, discharge …).
Cardinality0...1
TypeCodeableConcept
Binding
The type of diagnosis this condition represents
?? (preferred)
Comments

Not all terminology uses fit this general pattern. In some cases, models should not use CodeableConcept and use Coding directly and provide their own structure for managing text, codings, translations and the relationship between elements and pre- and post-coordination.

Invariants
  • ele-1: All FHIR elements must have a @value or children
    hasValue() | (children().count() > id.count())
Mappings
  • rim: n/a
  • v2: CE/CNE/CWE
  • rim: CD
  • orim: fhir:CodeableConcept rdfs:subClassOf dt:CD
Encounter.diagnosis.rank
DefinitionRanking of the diagnosis (for each role type).
Cardinality0...1
TypepositiveInt
Comments

32 bit number; for values larger than this, use decimal

Invariants
  • ele-1: All FHIR elements must have a @value or children
    hasValue() | (children().count() > id.count())
Mappings
  • rim: n/a
  • rim: .outboundRelationship[typeCode=RSON].priority
Encounter.account
DefinitionThe set of accounts that may be used for billing for this Encounter.
Cardinality0...*
TypeReference(http://hl7.org/fhir/StructureDefinition/Account)
Comments

The billing system may choose to allocate billable items associated with the Encounter to different referenced Accounts based on internal business rules.

Invariants
  • ele-1: All FHIR elements must have a @value or children
    hasValue() | (children().count() > id.count())
  • ref-1: SHALL have a contained resource if a local reference is provided
    reference.startsWith('#').not() or (reference.substring(1).trace('url') in %resource.contained.id.trace('ids'))
Mappings
  • rim: n/a
  • rim: The target of a resource reference is a RIM entry point (Act, Role, or Entity)
  • rim: .pertains.A_Account
Encounter.hospitalization
DefinitionDetails about the admission to a healthcare service.
Cardinality0...1
TypeBackboneElement
Comments

An Encounter may cover more than just the inpatient stay. Contexts such as outpatients, community clinics, and aged care facilities are also included.

The duration recorded in the period of this encounter covers the entire scope of this hospitalization record.

Invariants
  • ele-1: All FHIR elements must have a @value or children
    hasValue() | (children().count() > id.count())
Mappings
  • rim: n/a
  • rim: .outboundRelationship[typeCode=COMP].target[classCode=ENC, moodCode=EVN]
Encounter.hospitalization.id
Definitionunique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
Cardinality0...1
Typestring
Comments

Note that FHIR strings may not exceed 1MB in size

Invariants
  • ele-1: All FHIR elements must have a @value or children
    hasValue() | (children().count() > id.count())
Mappings
  • rim: n/a
Encounter.hospitalization.extension
DefinitionMay be used to represent additional information that is not part of the basic definition of the element. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.
Cardinality0...*
TypeExtension
Aliasextensions, user content
Comments

There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

SlicingUnordered, Open, by url(Value)
Invariants
  • ele-1: All FHIR elements must have a @value or children
    hasValue() | (children().count() > id.count())
  • ext-1: Must have either extensions or value[x], not both
    extension.exists() != value.exists()
Mappings
  • rim: n/a
  • rim: N/A
Encounter.hospitalization.modifierExtension
DefinitionMay be used to represent additional information that is not part of the basic definition of the element, and that modifies the understanding of the element that contains it. Usually modifier elements provide negation or qualification. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.
Cardinality0...*
TypeExtension
ModifierTrue
SummaryTrue
Aliasextensions, user content, modifiers
Comments

There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

Invariants
  • ele-1: All FHIR elements must have a @value or children
    hasValue() | (children().count() > id.count())
  • ext-1: Must have either extensions or value[x], not both
    extension.exists() != value.exists()
Mappings
  • rim: n/a
  • rim: N/A
Encounter.hospitalization.preAdmissionIdentifier
DefinitionPre-admission identifier.
Cardinality0...1
TypeIdentifier
Invariants
  • ele-1: All FHIR elements must have a @value or children
    hasValue() | (children().count() > id.count())
Mappings
  • rim: n/a
  • v2: CX / EI (occasionally, more often EI maps to a resource id or a URL)
  • rim: II - see see identifier pattern at http://wiki.hl7.org/index.php?title=Common_Design_Patterns#Identifier_Pattern for relevant discussion. The Identifier class is a little looser than the v3 type II because it allows URIs as well as registered OIDs or GUIDs. Also maps to Role[classCode=IDENT]
  • servd: Identifier
  • v2: PV1-5
  • rim: .id
Encounter.hospitalization.origin
DefinitionThe location from which the patient came before admission.
Cardinality0...1
TypeReference(http://hl7.org/fhir/StructureDefinition/Location)
Comments

References SHALL be a reference to an actual FHIR resource, and SHALL be resolveable (allowing for access control, temporary unavailability, etc). Resolution can be either by retrieval from the URL, or, where applicable by resource type, by treating an absolute reference as a canonical URL and looking it up in a local registry/repository.

Invariants
  • ele-1: All FHIR elements must have a @value or children
    hasValue() | (children().count() > id.count())
  • ref-1: SHALL have a contained resource if a local reference is provided
    reference.startsWith('#').not() or (reference.substring(1).trace('url') in %resource.contained.id.trace('ids'))
Mappings
  • rim: n/a
  • rim: The target of a resource reference is a RIM entry point (Act, Role, or Entity)
  • rim: .participation[typeCode=ORG].role
Encounter.hospitalization.admitSource
DefinitionFrom where patient was admitted (physician referral, transfer).
Cardinality0...1
TypeCodeableConcept
Binding
From where the patient was admitted.
?? (preferred)
Comments

Not all terminology uses fit this general pattern. In some cases, models should not use CodeableConcept and use Coding directly and provide their own structure for managing text, codings, translations and the relationship between elements and pre- and post-coordination.

Invariants
  • ele-1: All FHIR elements must have a @value or children
    hasValue() | (children().count() > id.count())
Mappings
  • rim: n/a
  • v2: CE/CNE/CWE
  • rim: CD
  • orim: fhir:CodeableConcept rdfs:subClassOf dt:CD
  • v2: PV1-14
  • rim: .admissionReferralSourceCode
Encounter.hospitalization.reAdmission
DefinitionWhether this hospitalization is a readmission and why if known.
Cardinality0...1
TypeCodeableConcept
Binding
The reason for re-admission of this hospitalization encounter.
?? (example)
Comments

Not all terminology uses fit this general pattern. In some cases, models should not use CodeableConcept and use Coding directly and provide their own structure for managing text, codings, translations and the relationship between elements and pre- and post-coordination.

Invariants
  • ele-1: All FHIR elements must have a @value or children
    hasValue() | (children().count() > id.count())
Mappings
  • rim: n/a
  • v2: CE/CNE/CWE
  • rim: CD
  • orim: fhir:CodeableConcept rdfs:subClassOf dt:CD
  • v2: PV1-13
Encounter.hospitalization.dietPreference
DefinitionDiet preferences reported by the patient.
Cardinality0...*
TypeCodeableConcept
Binding
Medical, cultural or ethical food preferences to help with catering requirements.
?? (example)
Requirements

Used to track patient's diet restrictions and/or preference. For a complete description of the nutrition needs of a patient during their stay, one should use the nutritionOrder resource which links to Encounter.

Comments

For example a patient may request both a dairy-free and nut-free diet preference (not mutually exclusive).

Invariants
  • ele-1: All FHIR elements must have a @value or children
    hasValue() | (children().count() > id.count())
Mappings
  • rim: n/a
  • v2: CE/CNE/CWE
  • rim: CD
  • orim: fhir:CodeableConcept rdfs:subClassOf dt:CD
  • v2: PV1-38
  • rim: .outboundRelationship[typeCode=COMP].target[classCode=SBADM, moodCode=EVN, code="diet"]
Encounter.hospitalization.specialCourtesy
DefinitionSpecial courtesies (VIP, board member).
Cardinality0...*
TypeCodeableConcept
Binding
Special courtesies
?? (preferred)
Comments

Not all terminology uses fit this general pattern. In some cases, models should not use CodeableConcept and use Coding directly and provide their own structure for managing text, codings, translations and the relationship between elements and pre- and post-coordination.

Invariants
  • ele-1: All FHIR elements must have a @value or children
    hasValue() | (children().count() > id.count())
Mappings
  • rim: n/a
  • v2: CE/CNE/CWE
  • rim: CD
  • orim: fhir:CodeableConcept rdfs:subClassOf dt:CD
  • v2: PV1-16
  • rim: .specialCourtesiesCode
Encounter.hospitalization.specialArrangement
DefinitionAny special requests that have been made for this hospitalization encounter, such as the provision of specific equipment or other things.
Cardinality0...*
TypeCodeableConcept
Binding
Special arrangements
?? (preferred)
Comments

Not all terminology uses fit this general pattern. In some cases, models should not use CodeableConcept and use Coding directly and provide their own structure for managing text, codings, translations and the relationship between elements and pre- and post-coordination.

Invariants
  • ele-1: All FHIR elements must have a @value or children
    hasValue() | (children().count() > id.count())
Mappings
  • rim: n/a
  • v2: CE/CNE/CWE
  • rim: CD
  • orim: fhir:CodeableConcept rdfs:subClassOf dt:CD
  • v2: PV1-15 / OBR-30 / OBR-43
  • rim: .specialArrangementCode
Encounter.hospitalization.destination
DefinitionLocation to which the patient is discharged.
Cardinality0...1
TypeReference(http://hl7.org/fhir/StructureDefinition/Location)
Comments

References SHALL be a reference to an actual FHIR resource, and SHALL be resolveable (allowing for access control, temporary unavailability, etc). Resolution can be either by retrieval from the URL, or, where applicable by resource type, by treating an absolute reference as a canonical URL and looking it up in a local registry/repository.

Invariants
  • ele-1: All FHIR elements must have a @value or children
    hasValue() | (children().count() > id.count())
  • ref-1: SHALL have a contained resource if a local reference is provided
    reference.startsWith('#').not() or (reference.substring(1).trace('url') in %resource.contained.id.trace('ids'))
Mappings
  • rim: n/a
  • rim: The target of a resource reference is a RIM entry point (Act, Role, or Entity)
  • v2: PV1-37
  • rim: .participation[typeCode=DST]
Encounter.hospitalization.dischargeDisposition
DefinitionCategory or kind of location after discharge.
Cardinality0...1
TypeCodeableConcept
Binding
Discharge Disposition
?? (example)
Comments

Not all terminology uses fit this general pattern. In some cases, models should not use CodeableConcept and use Coding directly and provide their own structure for managing text, codings, translations and the relationship between elements and pre- and post-coordination.

Invariants
  • ele-1: All FHIR elements must have a @value or children
    hasValue() | (children().count() > id.count())
Mappings
  • rim: n/a
  • v2: CE/CNE/CWE
  • rim: CD
  • orim: fhir:CodeableConcept rdfs:subClassOf dt:CD
  • v2: PV1-36
  • rim: .dischargeDispositionCode
Encounter.location
DefinitionList of locations where the patient has been during this encounter.
Cardinality0...*
TypeBackboneElement
Comments

Virtual encounters can be recorded in the Encounter by specifying a location reference to a location of type "kind" such as "client's home" and an encounter.class = "virtual".

Invariants
  • ele-1: All FHIR elements must have a @value or children
    hasValue() | (children().count() > id.count())
Mappings
  • rim: n/a
  • rim: .participation[typeCode=LOC]
Encounter.location.id
Definitionunique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
Cardinality0...1
Typestring
Comments

Note that FHIR strings may not exceed 1MB in size

Invariants
  • ele-1: All FHIR elements must have a @value or children
    hasValue() | (children().count() > id.count())
Mappings
  • rim: n/a
Encounter.location.extension
DefinitionMay be used to represent additional information that is not part of the basic definition of the element. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.
Cardinality0...*
TypeExtension
Aliasextensions, user content
Comments

There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

SlicingUnordered, Open, by url(Value)
Invariants
  • ele-1: All FHIR elements must have a @value or children
    hasValue() | (children().count() > id.count())
  • ext-1: Must have either extensions or value[x], not both
    extension.exists() != value.exists()
Mappings
  • rim: n/a
  • rim: N/A
Encounter.location.modifierExtension
DefinitionMay be used to represent additional information that is not part of the basic definition of the element, and that modifies the understanding of the element that contains it. Usually modifier elements provide negation or qualification. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.
Cardinality0...*
TypeExtension
ModifierTrue
SummaryTrue
Aliasextensions, user content, modifiers
Comments

There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

Invariants
  • ele-1: All FHIR elements must have a @value or children
    hasValue() | (children().count() > id.count())
  • ext-1: Must have either extensions or value[x], not both
    extension.exists() != value.exists()
Mappings
  • rim: n/a
  • rim: N/A
Encounter.location.location
DefinitionThe location where the encounter takes place.
Cardinality1...1
TypeReference(Location_apimin_v3)
Comments

References SHALL be a reference to an actual FHIR resource, and SHALL be resolveable (allowing for access control, temporary unavailability, etc). Resolution can be either by retrieval from the URL, or, where applicable by resource type, by treating an absolute reference as a canonical URL and looking it up in a local registry/repository.

Invariants
  • ele-1: All FHIR elements must have a @value or children
    hasValue() | (children().count() > id.count())
  • ref-1: SHALL have a contained resource if a local reference is provided
    reference.startsWith('#').not() or (reference.substring(1).trace('url') in %resource.contained.id.trace('ids'))
Mappings
  • rim: n/a
  • rim: The target of a resource reference is a RIM entry point (Act, Role, or Entity)
  • v2: PV1-3 / PV1-6 / PV1-11 / PV1-42 / PV1-43
  • rim: .role
  • w5: where
Encounter.location.status
DefinitionThe status of the participants' presence at the specified location during the period specified. If the participant is is no longer at the location, then the period will have an end date/time.
Cardinality0...1
Typecode
Binding
The status of the location.
?? (required)
Comments

When the patient is no longer active at a location, then the period end date is entered, and the status may be changed to completed.

Invariants
  • ele-1: All FHIR elements must have a @value or children
    hasValue() | (children().count() > id.count())
Mappings
  • rim: n/a
  • rim: .role.statusCode
Encounter.location.period
DefinitionTime period during which the patient was present at the location.
Cardinality0...1
TypePeriod
Comments

This is not a duration - that's a measure of time (a separate type), but a duration that occurs at a fixed value of time. A Period specifies a range of time; the context of use will specify whether the entire range applies (e.g. "the patient was an inpatient of the hospital for this time range") or one value from the range applies (e.g. "give to the patient between these two times"). If duration is required, specify the type as Interval|Duration.

Invariants
  • ele-1: All FHIR elements must have a @value or children
    hasValue() | (children().count() > id.count())
  • per-1: If present, start SHALL have a lower value than end
    start.empty() or end.empty() or (start <= end)
Mappings
  • rim: n/a
  • v2: DR
  • rim: IVL<TS>[lowClosed="true" and highClosed="true"] or URG<TS>[lowClosed="true" and highClosed="true"]
  • rim: .time
Encounter.serviceProvider
DefinitionAn organization that is in charge of maintaining the information of this Encounter (e.g. who maintains the report or the master service catalog item, etc.). This MAY be the same as the organization on the Patient record, however it could be different. This MAY not be not the Service Delivery Location's Organization.
Cardinality0...1
TypeReference(http://hl7.org/fhir/StructureDefinition/Organization)
Comments

References SHALL be a reference to an actual FHIR resource, and SHALL be resolveable (allowing for access control, temporary unavailability, etc). Resolution can be either by retrieval from the URL, or, where applicable by resource type, by treating an absolute reference as a canonical URL and looking it up in a local registry/repository.

Invariants
  • ele-1: All FHIR elements must have a @value or children
    hasValue() | (children().count() > id.count())
  • ref-1: SHALL have a contained resource if a local reference is provided
    reference.startsWith('#').not() or (reference.substring(1).trace('url') in %resource.contained.id.trace('ids'))
Mappings
  • rim: n/a
  • rim: The target of a resource reference is a RIM entry point (Act, Role, or Entity)
  • v2: PV1-10 / PL.6 & PL.1 (note: HL7 v2 definition is "the treatment or type of surgery that the patient is scheduled to receive"; seems slightly out of alignment with the concept name 'hospital service'. Would not trust that implementations apply this semantic by default)
  • rim: .particiaption[typeCode=PFM].role
Encounter.partOf
DefinitionAnother Encounter of which this encounter is a part of (administratively or in time).
Cardinality0...1
TypeReference(http://hl7.org/fhir/StructureDefinition/Encounter)
Comments

This is also used for associating a child's encounter back to the mother's encounter.

Refer to the Notes section in the Patient resource for further details.

Invariants
  • ele-1: All FHIR elements must have a @value or children
    hasValue() | (children().count() > id.count())
  • ref-1: SHALL have a contained resource if a local reference is provided
    reference.startsWith('#').not() or (reference.substring(1).trace('url') in %resource.contained.id.trace('ids'))
Mappings
  • rim: n/a
  • rim: The target of a resource reference is a RIM entry point (Act, Role, or Entity)
  • rim: .inboundRelationship[typeCode=COMP].source[classCode=COMP, moodCode=EVN]